Achilles Tendon Injuries - PowerPoint PPT Presentation

Achilles Tendon Injuries. Michael LaBella. Objectives. To be able to identify the difference between Achilles Tendinitis and an Achilles Rupture. How a coach could evaluate an Achilles injury. Post surgery rehabilitation programs to be able to return to play after the rupture of an Achilles.

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The Achilles tendon is the tendon that connects the calf muscle (gastrocnemius) to the heel bone (calcaneus). This is the tendon that is just below the skin at the back of the ankle. As with most tendon injuries, this tendon may be injured.

When the gastrocnemius muscle (in the calf) contracts (shortens), the tendon which is attached from the muscle to the heel bone (calcaneus) moves. As the muscle shortens, the tendon moves to point the foot downwards. This is the action that allows a person to stand on one's toes, to run, to jump, to walk normally, and to go up and down stairs.

Surgery is a common treatment for a complete rupture of the Achilles tendon. The procedure generally involves making an incision in the back of your lower leg and stitching the torn tendon together. Depending on the condition of the torn tissue, the repair may be reinforced with other tendons.

The patient may do this mainly as an independent program if appropriate

Progress to Phase II when:

-tolerates all Phase I without pain or significant increase in swelling-ambulates FWB (full weight bearing) without device-ROM for plantar flexion, inversion and eversion are normal-dorsi flexion is at approximately neutral

Sitting calf raises to standing at (generally 8-10 weeks)BAPS board standing (with support as needed)Step upsStep downsUnilateral stance; balance activities with challenges if appropriate (such as ground clock)Mini-squats – bilateral to unilateralStairmaster – short steps 4", no greater than level 4 if no pain or inflammationMay continue pool if appropriate

May be 2X/wk or to independent as appropriate

Progress to Phase III when:

-cleared by physician-can do each of Phase II activities without pain or swelling-ROM equal bilaterally-able to do bilateral calf raise without difficulty and weight equal bilaterally-unilateral stance balance equal bilaterally